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Objective: To determine the predictive value of repeated abdominal ultrasonography in patients with multiple trauma and decreased level of consciousness [LOC]
Methods: This prospective cross-sectional study was conducted over a six-month period at Shahid Rajaee Trauma Hospital, Shiraz, Iran. We included hemodynamically stable blunt abdominal trauma patients with a decreased LOC [Glasgow Coma Scale
Results: Overall 80 patients with mean age of 37.75 +/- 18.67 years were included. There were 17 [21.3%] women and 63 [78.8%] men among the patients. Compared with the CT-Scan, the first ultrasonography showed a sensitivity of 60%, specificity of 80%, PPV of 16.60%, NPV of 96.80%, and a diagnostic accuracy of 70%. The same values for the second ultrasonographic study were 80%, 79%, 20%, 98%, and 79%, respectively. In 4 [5%] patients whose first ultrasonography and CT scan results were negative, the second ultrasonography was positive for injury
Conclusion: In patients with blunt trauma to the abdomen, when the only indication of abdominal CT scan is a decreased LOC, two ultrasonographic studies can replace a CT imaging
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Objective: To determine the effects of pregnancy on the presentation, management, surgical and obstetrics outcome of patients with acute appendicitis
Methods: This prospective cohort study was conducted during a 2-year period from 2014 to 2016 in Shahid Faghihi hospital of Shiraz University of Medical Sciences. We enrolled all the pregnant individuals with acute appendicitis who required surgical appendectomy. We also enrolled age-matched controls of non-pregnant women undergoing open appendectomy during the study period. The presentation, clinical and laboratory characteristics, surgical and obstetrics outcomes were determined in both study groups and were further compared between them. In order to determine the determinants of outcome, we also ran a multivariate logistic regression model
Results: Overall we included a total number of 584 patients with presumed appendicitis among whom there were 58 [9.94%] and 526 [90.06%] non-pregnant individuals. The pregnant patients had significantly longer duration of symptoms [p=0.038], lower temperature [p=0.026], longer duration of hospital stay [p=0.026] and higher rate of hospital admission longer than 2 days [p=0.031]. The complications of the surgical procedure were comparable between the two study groups except for the pneumonia which was significantly higher in pregnant patient [p=0.041]. After adjusting for confounders such as age and ethnicity, pregnancy remained significantly associated with lower temperature [p=0.018], longer symptom duration [p=0.042] and higher rate of pneumonia [p=0.049]
Conclusion: Acute appendicitis during the pregnancy was associated with longer duration of symptoms, lower body temperature and higher rate of pneumonia. The pregnancy and neonatal outcomes were comparable to the previously reported data
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Objective To investigate the effect of Iranian honey, cinnamon and their combination against Streptococcus mutans bacteria. Methods Nine experimental solutions were examined in this study, including two types of honey (pasteurized and sterilized), two types of cinnamon extract (dissolved in distilled water or dimethyl sulfoxide) and five different mixtures of cinnamon in honey (prepared by admixing 1%–5% w/w of cinnamon extract into 99%–95% w/w of honey, respectively). Meanwhile, each of mentioned agent was considered as the first solution while it was diluted into seven serially two-fold dilutions (from 1:2 to 1:128 v/v). Therefore, eight different concentrations of each agent were tested. The antibacterial tests were performed through blood agar well diffusion method, and the minimum inhibitory concentration (MIC) was determined. Ultimately, the data were subjected to statistical analysis incorporating Two-way ANOVA and Bonferroni post hoc tests (α = 0.01). Results The highest zone of inhibition was recorded for the mixtures of honey and cinnamon while all the subgroups containing 95%–99% v/v of honey were in the same range (P < 0.01). The MIC for both honey solutions were obtained as 500 mg/mL whereas it was 50 mg/mL for both cinnamon solutions. Moreover, the MIC related to all honey/cinnamon mixtures were 200 mg/mL. Conclusions A profound synergistic effect of honey and cinnamon was observed against Streptococcus mutans while there was no significant difference among extracts containing 99%–95% v/v of honey admixing with 1%–5% v/v of cinnamon, respectively.
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Objective: To record and classify mechanisms of injury and injury severity score [ISS] in trauma patients admitted to the largest trauma center in Southern Iran
Methods: This was a prospective cross-sectional study including all the patients who were admitted to Nemazee hospital from 2009 to 2010. We recorded the trauma injury information of 1217 patients who were admitted to of emergency room of the Nemazee hospital during a 13-months period by means of a standard questionnaire. ISS was then obtained for every single patient
Results: The mean age of patients was 26.6 +/-15.1 [range 1-95] years. The commonest type of trauma including 279 cases [22.9%] was car accident and the least resulted from shotgun injuries in 13 [1.1%] patients. The lowest ISS was due to assault multiple blunt traumas and the highest ISS resulted from shotgun injury. The mean ISS was about 6.3 +/- 1.8 [range 1-66]. Overall, 86 patients had scores above 17 [7.1%]. A total of 69 male patients [7.5%] compared to 17 females [5.7%] had severe injury [ISS>17]. Trauma injuries were significantly more severe in males compared to females [p=0.014]. In the sunny and hot seasons total number of patient was higher. The mean ISS was highest in during spring [p<0.001]
Conclusion: In Shiraz, most of the trauma injuries are occurred during summer and hot weather. Men have greater number of injuries and higher ISS compared to women. The lowest ISS was due to assault multiple blunt trauma and the highest ISS was caused by shotgun injury, and car accident was the commonest cause of trauma with head and neck being the most frequent sites in our patients
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Ventilator-Associated pneumonia [VAP] is the second common infections with high mortality [24-40%].In this study designed to determined effect of continuous[infusion] and intermittent[bolus] feeding on the Ventilator-associated Pneumonia in ICU Patient. This randomized controlled trial was performed on 76 patients admitted in ICU. They were randomly allocated to equal two groups [n=38]. In case group, continuous feeding and in controlled group intermittent feeding was performed during the first five days. The incidences of early pneumonia [the first 3 to 5 days] and increase WBC [White Blood Cell] and PMN [Poly Morph Nuclear] in both groups were compared during the first 5 days. The rate of increase in WBC [>11000/ml] and PMN [band cell>50%] in continuous group was 8 patients [10.5%] and in intermittent group were 7 patients [9.2%] [pv=0.32]. The incidences of early pneumonia [CPIS >or=6] in case group were 4 patients [5.3%] and in control group were 7 patients [9.2%] [pv=0.77]. The results of this study showed that incidence of early VAP in case group was lesser, but this difference was not significant. Also, there was no significant difference in increase of WBC and PMN in both groups
Subject(s)
Humans , Feeding Methods , Intensive Care UnitsABSTRACT
Background and Aim: Equipments and surfaces in dental clinics and centers are always in risk of contamination. When there is no possibility of sterilizing them, fast acting disinfecting agents are used. In this study, antibacterial effect of a new disinfecting solution, named Nanex,against streptococcus mutans and pseudomonas aeroginosa was compared with pure Nano silver solution and Deconex 53 plus
Materials and methods: In this experimental study, in order to determine the effective antibacterial concentration , serial dilution technique ,evaluation of [MIC] and [MBC] were used. Finally bacterial growth was assessed
Results: The # 4 solution [containing 100 ppm Nano silver and 2% Deconex] showed the least MIC and MBC for streptococcus mutans. The # 7 solution [containing 133 ppm Nano silver and 1% Deconex] showed the least MIC and MBC for psuedomonas aerogenosa
Conclusion: Thus, antibacterial effect of Nanex solution was more potent and effective than pure solution of nano silver and deconex
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Background: The objective of this study was to investigate the amount of medical society's knowledge about the role of physiotherapy in treating and improving the confined patients
Methods: A questionnaire has prepared with five clinical questions by multiple choice items. The volunteers have one or more items to choice. These questionnaires have randomly completed by the medical students of the Medical Universities around Iran
Results: Our results have shown that only 47.5% of physicians are familiar with the role of physiotherapy for treating and improving restricted patients, on the other hand 18.6% prescribed unsuitable, expensive, and even harmful techniques for curing these patients
Conclusion: The results of our study emphasis on the limited knowledge and information of the medical society about physiotherapy. Even in some cases that the role of physiotherapy has proven, they are not familiar with it. It may reflect the lack of medical training program and their educational syllabus
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Mycoplasma hominis and Ureaplasma urealyticum microorganisms may play a role in infertility. The aim of this study is to determine prevalence of Mycoplasma hominis and Ureaplasma urealyticum microorganisms in infertile women and their husbands. In this Cross-sectional study presence of Mycoplasma hominis and Ureaplasma urealyticum were examined in infertile couples who have been referred to infertility clinics [Avicenna Institute in Tehran] by gynecologists. Referred patients with cervical smear and their husbands with semen fluid culture were asked to fill in a questionnaire. The samples were sent to microbiology laboratories. Data were analyzed using SPSS and Chi-square, Mann-Whitney and T-test methods. 56 infertile women and their husbands were studied and compared. The average age in subjects was 30.41 year and their marriage age was 22.96 year. Prevalence of Mycoplasma hominis in women was 27.39% [22 out of 56] and in their husbands was 19.64% [11]. Prevalence of Ureaplasma urealyticum in women was 58.92% [33] and in their husbands was 46.42% [26]. There was no statistically significant differences between the infection and patient age, marriage age, educational levels and infertility duration. This study showed a high prevalence of mycoplasma hominis and ureaplasma urealyticum infection in both infertile women and their husbands. However, the prevalence of infections in women was higher than their husbands. We concluded that treatment of infected women is necessary and further studies are required to be done to better understand the role of these infections in infertility of women
Subject(s)
Humans , Male , Female , Mycoplasma hominis/isolation & purification , Ureaplasma urealyticum/isolation & purification , Prevalence , Cross-Sectional Studies , SpousesABSTRACT
Human papillomavirus [HPV] is associated with various benign and malignant lesions including genital condyloma and anogenital cancer. The presence of HPV-DNA was studied in archival biopsies of high- and intermediate-risk lesions for cervical carcinoma in women referred to Mirza hospital in Tehran. Totally, 105 Iranian archived biopsies collected during February and November 2006. HPV-DNA was isolated from the biopsies and detected by means of consensus polymerase chain reaction [PCR] detecting a broad spectrum of genital HPV types. Totally, 26 samples [24.7%] were positive for oncogenic HPV-DNA. Risk of HPV infection was significantly higher in biopsies obtained from patients with confirmed squamous cell carcinoma [SCC] who started sexual activity more recently [/= 10 years ago]. HPV-16 was more frequently detected in biopsies of younger women. HPV was more frequently detected in young women. Our data confirm the usefulness of this method for detection of HPV in archival biopsies
Subject(s)
Humans , Female , Uterine Cervical Neoplasms/virology , Uterine Cervical Neoplasms/pathology , Polymerase Chain Reaction , Hospitals, TeachingABSTRACT
Introduction: Certain types of human papillomavrus [HPV] are associated with cervical intraepithelial neoplasia [CIN] and squamous cell carcinoma [SCC]. The aim of the observations reported here was to determine whether the prognosis for invasive cancers of the uterine cervix is related to the type of human papillomavirus asociated with the tumor
Material and Methods: Twenty Patients with invasive cervical cancer were prospectively registered from 2000 to 2001. HPV typing was performed by insitu hybridization [ISH] on DNA extracted from frozen, formal in-fixed, paraffin-embedded tumor specimens. The specimens mostly represented classifications SCC Stage 1 and Stage 2 of the International Federation of Gynecology and Obstetrics [Table 1]. HPV- DNA was detected by insitu hybridization, using three different DNA Probes: types 6/11, 16/18 and 31/33/51
Results: HPV DNA was detected in the nuclei of SCC tumor cells in 13[65%] of 20 cases. Of the 13 HPV-DNA positive cases three reacted only with the HPV 31/33/51 probe, two reacted only with the 16/18 probe, three showed strong hybridization for both 31/33/51 and 6/11probes, four showed 6/11 and 16/18 genotypes and one case reacted with 31/33/51,6/11 and 16/18 probes
Conclusion: The prognosis for invasive cancers of the uterine cervix is dependent on the oncogenic potential of the associated HPV type. HPV typing may provide a prognostic indicator for individual patients and is of potential use in defining specific therapies against HPV harboring tumor cells. These findings are consistent with the hypothesis that HPV infection is the primary cause of cervical neoplasia. Furthermore, they support HPV vaccine research to prevent cervical cancer and efforts to develop HPV DNA diagnostic tests